Lotito Michelle Coelho Ferreira, Pinto Ana Clara Tapajos, Alves Leticia Carolina, Barbosa Mainara Alves, Ferreira Dennis Carvalho, Portela Maristela Barbosa, Pereira Antônio Ferreira, Tavares-Silva Claudia Maria, Pastura Giuseppe, de Araújo Castro Gloria Fernanda Barbosa
Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro - UFRJ, Rua Professor Rodolpho Paulo Rocco, 325 Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, CEP: 21.941-617, Brazil.
School of Nursing, Universidade Estadual Do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
J Autism Dev Disord. 2025 Jul 10. doi: 10.1007/s10803-025-06925-6.
The study described the sleep characteristics (SC) of children/adolescents with Autism Spectrum Disorder (ASD), and examined their association with medication use, support level, chronotype, probable sleep bruxism (PSB), anxiety, salivary levels of cortisol (SalC) and melatonin (SalM). Methods: Following anamnesis and dental examination, anxiety was assessed using the SCARED questionnaire. The SCs were determined by two age-appropriate questionnaires, and the percentage of negative SCs (%Neg) was recorded. Saliva samples were collected to measure SalC and SalM levels. The sample comprised 85 ASD patients aged 2-16 years, of whom 80%, 50.6% were classified as support level 2, 83.5% used medication, 84.7% had an afternoon chronotype, 72.9% presented PSB, and 48.2%, anxiety. The mean %Neg was significantly higher in patients using medication (49.29 ± 15.88; p = 0.03) and those requiring more support (level 1: 41.57 ± 14.45; level 2: 50.78 ± 15.54; level 3: 55.11 ± 23.44; p = 0.019). Patients with anxiety showed a higher %Neg (51.31 ± 16.33) than those without anxiety (43.65 ± 15.79). The mean SalC and SalM levels were 13.29 ± 13.39 and 299.91 ± 241.77, respectively.. In children aged 2-6 years, one rhythmicity SC and two separation-related SCs were associated with SalC (p < 0.05); lower SalM levels were found in patients who "slept alone" (p = 0.02). In older patients, "moving while sleeping" was associated with lower SalC (p = 0.05), and three additional SCs were linked to reduced SalM levels (p < 0.05). The presence of negative SCs in ASD patients was more common in those taking medication, requiring more support, and presenting anxiety. Furthermore, SalC and SalM levels were associated with specific SCs, especially among individuals aged (7-16).
该研究描述了自闭症谱系障碍（ASD）儿童/青少年的睡眠特征（SC），并研究了这些特征与药物使用、支持水平、昼夜节律类型、可能的睡眠磨牙症（PSB）、焦虑、唾液皮质醇（SalC）和褪黑素（SalM）水平之间的关联。方法：在进行问诊和牙科检查后，使用SCARED问卷评估焦虑情况。通过两份适合年龄的问卷确定SC，并记录负面SC的百分比（%Neg）。收集唾液样本以测量SalC和SalM水平。样本包括85名2至16岁的ASD患者，其中80%、50.6%被归类为支持水平2，83.5%使用药物，84.7%具有下午型昼夜节律，72.9%存在PSB，48.2%存在焦虑。使用药物的患者（49.29±15.88；p = 0.03）和需要更多支持的患者（水平1：41.57±14.45；水平2：50.78±15.54；水平3：55.11±23.44；p = 0.019）的平均%Neg显著更高。有焦虑的患者的%Neg（51.31±16.33）高于无焦虑的患者（43.65±15.79）。SalC和SalM的平均水平分别为13.29±13.39和299.91±241.77。在2至6岁的儿童中，一种节律性SC和两种与分离相关的SC与SalC相关（p < 0.05）；“独自睡觉”的患者SalM水平较低（p = 0.02）。在年龄较大的患者中，“睡觉时移动”与较低的SalC相关（p = 0.05），另外三种SC与较低的SalM水平相关（p < 0.05）。ASD患者中负面SC的存在在服用药物者、需要更多支持者和有焦虑者中更为常见。此外，SalC和SalM水平与特定的SC相关，尤其是在7至16岁的个体中。
